With the new year knocking on the door, physicians, their billing teams, and the entire hospital medical billing industry are rethinking the strategies that could yield better results. With the sector undergoing several permanent and temporary changes over the last two years due to the changing nature of the global pandemic, revenue cycle leaders are looking forward to 2022 to ensure that they reverse their losses and improve their collections. Automation technology has also played a massive part in enhancing workflow management, which several health systems are adopting quickly to eliminate manual errors.
The hospital medical billing industry must strategize its working patterns for the next year early on to adjust well to the changing federal rules. When it comes to planning a strategy in the medical billing industry, revenue cycle management is one of the highest priorities on the list. Maximizing reimbursements by reducing the cost to collect for good financial health is the ultimate goal of every healthcare organization. Here are some of the strategies leaders are thinking about implementing in 2022.
Risk-based Reimbursement Models                             Â
- Risk-based reimbursement models have always been one of the most value-yielding financial models for a provider organization.
- However, risk-based payment models have shown a significant slowdown due to the lesser interests of various medical industry sectors.
- Currently, revenue leaders will focus on these models in the upcoming year, provided that the healthcare providers are equally interested in participating.
- According to a statement from the Centers for Medicare & Medicaid Services Chief Operating Officer Jon Blum, the CMS will not promote every risk-based model without careful evaluation.
- According to Jon Blum, the CMS will only be looking for risk-based payment models that support value-based care goals and close down the health equity gaps.
Reviewing Payer Contracts with New Goals
- The American healthcare industry is making a significant shift to the value-based healthcare model from the fee-for-service model.
- When it comes to implementing the same goals in a medical billing ecosystem, revenue leaders are reviewing the existing payer contracts of the providers to see if they are aligned with their goals.
- Assigning quality metrics is one of the top priorities of the value-based care model. The top leaders are trying to incorporate such factors into the agreement system.
- Several provider organizations are also teaming up with different strategic advisory firms to ensure that they can deliver superior patient care plans while decreasing administrative costs.
- Several top health systems of the country are also trying to engage with the different care providers like doctors and ancillary providers on individual levels to get maximum participation.
Increased Focus on Primary Care
- Primary care physicians have a crucial role to play in a value-based care model. Thus, the focus on primary care increases as value-based care models come into the front end of the picture.
- Healthcare systems are now looking for payment models and contracts that recognize the contribution of the primary care providers with improved compensation.
- Certain contracts with a specific focus on primary physicians with cognitive specialties are also becoming increasingly popular among the hospital medical billing teams.
- Accepting evolved compensation models with greater scope for primary care has also proved to increase the productivity of the organizations by over 10%.
- In the coming year, healthcare organizations are following the recently released CMS physician payment schedule to determine which of the compensations will give a better yield.
Related: 4 Things To Check Before Outsourcing Hospital Billing Services
Building Better Team Models
- Revenue leaders of 2022 are looking beyond the usual factors of hospital medical billing to expand their revenue streams. One of the most challenging issues emerging from this year has been staff shortage.
- Hospitals and other health systems are reeling under surmounted pressure with decreasing number of staff and increasing elective care in a post-pandemic situation.
- This has led to severe pressure on healthcare professionals who are trying to manage the patients’ clinical care plans as well as the manual billing procedures for timely reimbursements.
- According to a study conducted by the Physicians Foundation, both 2020 and 2021 showed high levels of healthcare provider burnout, 58% and 40%, respectively.
- Healthcare management has thus kept building better team models as one of the priorities in the upcoming year to prevent physician burnout and ensure the smooth functioning of the clinic.
Implementing Automation in Workflows
- The hospital medical billing system could prevent some common errors and improve their collections with a better-managed workflow.
- Using advanced automation in workflow management can prove to be a great way to boost the entire ecosystem while keeping costs in check.
- Dyadic team models are also emerging to be helpful in implementing automation to workflows, with shared responsibility between the administrator and the physicians.
- Provider organizations are gradually adopting advanced software models to keep all stakeholders on a single platform.
- The improved workflows help expedite the billing procedures, help identify and rectify the manual errors, and reduce the time lags in administrative procedures.
Continued Service for Telehealth
- Telemedicine saw a major boost since the beginning of the pandemic, with several permanent and temporary changes in reimbursement models brought by the federal and state agencies.
- However, healthcare management has identified telehealth as a permanent gateway to decreased workload and increased value over time.
- In a research conducted by Deloitte, 49% of the physicians participating in the study said that telemedicine had improved their job satisfaction.
- They were also enthusiastic about the involvement of automation resources in their daily workflow to save time and resources.
- Keeping this trend in mind, hospital medical billing will keep on working on various aspects of telehealth, though the in-office visits have gone up significantly.
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